Psychology

Schizotypal Personality Disorder is a condition characterized by acute discomfort with and desire for intimate relationships. Affected individuals try to avoid or distance themselves from social and interpersonal relationships (AMA, 2000). They tend to seclude themselves into lonely isolation, drifting unconsciously from one activity to another. These individuals show some proneness to cognitive and perceptual distortions and a display a variety of eccentric behaviors which others often find confusing Theodore 1996). They could be weird and sometimes totally strange, e.g. making utterances that are so abstract and meaningless. In some cases, they may experience brief psychotic episodes.

Individuals suffering from Schizotypal Personality Disorder exhibit a variety of symptoms and associated features, among them the following
Incorrectly interpreting events, because they lack the ability to link cause and effect of situations. For instance, if a person is amused by something and laughs as a result, they will interpret it is at their expense. They have distorted perceptions of the reality around them and as such, have a unique understanding of events.

They try to cope with the real world through magical thinking and odd beliefs (Theodore, 1996, AMA 2000).  Their speech patterns (Berkow and Beers 1999) may appear strange in terms of phrasing and sentence structuring.

They are generally paranoid, suspicious of other people and show uneasiness in public and social gatherings,  (Hirsh and Weinberger, 2003) and are often aloof when in the company of strangers (Millon, 1996).

Their unusual mannerisms and unconventional dressing style (Millon, 1996) make them look odd, with unkempt hair and ill-fitting clothes.

Psychologically, they are socially anxious, experience stress and mild forms of depression (AMA, 2003). Even when exposed to the same situation for long, their anxiety still persists. On the contrary, , it may progress into distorted perceptions of paranoia involving the people with whom they are in social contact (Millon, 1996).

The prevalence of SPD is normally 3 among the general public (Berkow and Beers 1999). However, it is common in families with people suffering from related conditions such as schizophrenia. It usually affects adults, but can begin in late childhood and early adolescence, with a high prevalence among males. At this stage, children exhibit solitariness, poor academic performance and poor peer relationships (AMA, 2003). The initial stages of development (Millon, 1996), is marked by hypersensitivity to criticism or correction, unusual use of language, odd thoughts, or bizarre fantasies. Consequently, they may attract teasing from other children due to their uniqueness. Over time, it may, though rarely, lead to more chronic conditions like schizophrenia and other psychotic disorders (AMA, 2003).

Accurate diagnosis for SPD is often difficult due to the close similarities of its symptoms with other disorders like schizoid personality disorder and schizophrenia. The unusual and bizarre thinking tendencies associated with SPD can be perceived as a psychotic episode and misdiagnosed (AMA, 2000). While short lived episodes of psychosis can occur in the patient with schizotypal personality disorder (Hirsh, Weinberger 2003  Millon 1999), the psychosis is not as severe, frequent, or as intense as in schizophrenia. Sometimes it precedes Chronic Axis I Personality Disorder or Schizophrenia (AMA 2000), in which case it is diagnosed as premorbid. Other related disorders include Expressive and Mixed Receptive-Expressive Language Disorder, which is distinguished by severe disability in language use. It occurs in childhood, in which case the child compensates lack of language fluency with the accompaniment of gestures. Some mild forms, like Aspergers Disorder are characterized by a higher degree of anti-social tendencies, and are usually exhibited as stereotypical behaviors e.g. introverts. SPD is also distinct from disorders resulting from substance abuse like cocaine.

Paranoia and Schizoid Personality Disorder have some common characteristics with SPD, such as social detachment and lack of desire for intimate relationships (AMA 2000). However, they do not exhibit the cognitive perceptual distortions present in SPD. People suffering from Avoidance Personality Disorder also show a dislike for social interaction and prefer isolation. But in their case, the behavior stems from as a sense of rejection rather than lack of desire and suspicion (AMA, 2000). Similarly, individuals suffering from Narcissistic Disorders tend to be suspicious of others, but their suspicions are largely due to physical or other imperfections and flaws.

Biological causes of Schizotypal Personality Disorders are linked with brain damage, especially in the prefrontal cortex, the part of the brain responsible for regulating emotion and impulse control (Nevid, 2008). Nash and Bernstein (2008) link SPD to the abnormal development of the brain and the impairment of  neurological functioning as a result of damage. It could also be genetically associated with family history (Gabbard, 2005). Johnson et al (2006) attributes environmental factors like parental abuse, neglect, harsh punishment or rejection (qtd. in Nevid, 2008). Andreasen and Black (2006) say that SPD is genetically related to Schizophrenia. In family and adoption studies, is has been discovered that it is prevalent in identical twins than non-identical ones. Additionally, children of anti- social children adopted by normal parents in childhood develop SPD related disorders (Andreasen and Black 2006).

The treatment of SPD is not aimed to restructure the personality of individuals, but help then interact more effectively in relationships (Millon 1996). Psycho-dynamically oriented therapies attempt to create intimate relationships with individuals so as to counter their suspicions and mistrusts for other people. Cognitive Behavioral therapy aims to change the content of the patients thoughts, so as to reduce anxieties and depressions which distort their perceptual processes. By use of interpersonal therapy, the individual is helped to adopt reality-based conceptions of events, by gaining insight into the distorted thinking that affects their perceptions.

Medication for SPD is intended to treat symptoms rather than the condition itself. Antipsychotic drugs are used to reduce illusions, anxiety and phobia. The anti-depressant amoxapine and fluoxetine relieve depressions in schizotypal patients (Millon, 1996).

Nonetheless, the condition cannot be completely cured by medication, at least as of today. Given the poor coping mechanisms of such patients, it makes it difficult to successfully administer treatment therapies. As it turns out, since the condition is genetically and environmentally triggered, prevention measures should be taken, such as establishing intimate relationships with patients creating trust, as well as encouraging their involvement in social activities.